Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE) on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) in individuals with supraspinatus tendinopathy. Participants (n = 50) were divided into two groups; they received 4 treatment sessions, 1 per week, of PE and PNS (n = 25) or 10 treatment sessions of TENS and US (n = 25). Both groups performed the EE program consisting of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p < 0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment with PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Fibromyalgia is a chronic condition characterized by musculoskeletal pain. The aim of this study was to synthesize scientific evidence on the effects of aquatic exercise programs on pain and quality of life in individuals with fibromyalgia. This review was carried out using the following databases in January 2024: Cochrane Library, PEDro, PubMed, SCOPUS, and Web of Science. Four clinical trials focusing on aquatic exercise as a treatment for patients with fibromyalgia were selected. These trials were published in English between 2019 and 2024. Pain recorded using the Visual Analog Scale (VAS) and quality of life with the Short Form-36 Health Survey (SF-36) or Fibromyalgia Impact on Quality of Life (FIQ) were the most commonly analyzed variables. This review was carried out according to the PRISMA statement and was registered in PROSPERO (CRD42024510219). The results in terms of pain and quality of life were positive. In conclusion, these findings support the incorporation of aquatic exercise into fibromyalgia physical therapy treatment. However, the benefits could be equivalent to those of other exercise modalities, underscoring the need for individualized adaptation to each patient’s needs.

BACKGROUND: Stroke is a clinical syndrome that can cause neurological disorders due to a reduction or interruption in the blood flow at the brain level. Transcranial direct current stimulation (TDCS) is a non-invasive electrotherapy technique with the ability to modulate the function of nervous tissue. OBJECTIVE: The aim of this review is to analyze the effects derived from the application of the TDCS for post-stroke patients on functionality and mobility. METHODS: The data search was conducted in PubMed, PEDro, Cochrane Library, Web of Science and Scopus between July and August 2023. The search focused on randomized clinical trials conducted in the period of 2019–2023, and according to the selection criteria, seven studies were obtained. RESULTS: The results found are mainly focused on the analysis of the scales Fugl-Meyer Assessment for Upper Extremity and Wolf Motor Function Test. CONCLUSION: The application of TDCS presents benefits in post-stroke individuals on functionality, mobility and other secondary studied variables.

Objectives: This study aimed to investigate the efficacy of Percutaneous Electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS), and Eccentric Exercise (EE) in patients with supraspinatus tendinopathy. Methods: Forty-six participants with supraspinatus tendinopathy were randomly allocated to either an invasive therapy group (four sessions in four weeks of PE+PNS and EE program) or a conventional physical therapy group (ten sessions for 2 weeks). The multimodal physical program included Ultrasound therapy (US), Transcutaneous Electric Nerve Stimulation (TENS) and the same EE program. The Numerical Pain Rating Scale (NPRS), shoulder Range of Motion (ROM), Pressure Pain Threshold (PPT), and disability (DASH and SPADI) were measured at baseline, at the end of treatment, and at 12- and 24-weeks follow-up. Results: The PE+PNS+EE group demonstrated consistently greater and statistically significant improvements across nearly all pain, mobility, and functional outcomes at all follow-up points (post-treatment, 12-weeks, and 24-weeks) compared to the TENS+US+EE group, with generally medium to large effect sizes. Conclusions: This study concludes that the combined PE+PNS+EE intervention offers safe and effective treatment for supraspinatus tendinopathy, demonstrating statistically significant improvements in pain, mobility, and function compared to conventional electrotherapy.

Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE), on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) on individuals with supraspinatus tendinopathy. Participants (n=50) were divided into two groups, they received 4 treatment sessions, one per week, of PE and PNS (n=25) or 10 treatment sessions of TENS and US (n=25). Both groups performed EE program consisted of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p<0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Patellar tendinopathy is a chronic musculoskeletal condition characterized by localized pain and functional impairment. This systematic review and exploratory meta-analysis aimed to synthesize current evidence on the effectiveness of percutaneous electrolysis (PE), combined with eccentric exercise, for improving functional performance in individuals with patellar tendinopathy. Following PRISMA guidelines and registration in PROSPERO (CRD420251233971), comprehensive searches were performed in Cochrane Library, PEDro, PubMed, ScienceDirect, Scopus, and Web of Science databases. Only two randomized controlled trials, published between 2016 and 2021, met the eligibility criteria and were included in the quantitative synthesis. Functional capacity recorded using the Victorian Institute of Sport Assessment-Patella (VISA-P) scale was the primary outcome. Both included studies presented some concerns regarding risk of bias. The pooled random-effects meta-analysis (REML estimation with Hartung–Knapp–Sidik–Jonkman adjustment) revealed no statistically significant difference favoring PE over control interventions (Hedges’ g = –0.10; 95% CI: –2.69 to 2.50; p = 0.72). Statistical heterogeneity was nominally low (I² = 0%), although this metric is uninformative with only two studies. Between-group differences in both studies were below the minimal clinically important difference for the VISA-P scale. The certainty of evidence according to the GRADE framework was rated as very low. Given the extremely limited evidence base, these findings should be considered strictly exploratory. The very low certainty of evidence precludes definitive conclusions regarding the comparative effectiveness of PE. Larger, adequately powered randomized trials with standardized protocols and long-term follow-up are needed.